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A failed prior Latarjet procedure can be a challenging situation for both patients and surgeons. The purpose of this study was to report on the techniques and outcomes of patients undergoing revision surgery for the treatment of recurrent anterior shoulder instability after a failed Latarjet procedure. A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies which reported on surgical techniques for a failed Latarjet procedure with reporting of clinical outcomes. The search terms used were Latarjet failed. Patients were evaluated based on revision method, patient-reported outcome measures (PROMs), reoperation rates, recurrent instability, overall satisfaction, and return to sports and work. Thirteen studies (all Level IV evidence) met inclusion criteria, including a total of 293 shoulders with a mean age of 28.3 years (range, 16-55 years) at the time of surgery. The mean follow-up time was 50.4 months (range, 14.0-208.0 months) and males accounted for 78.6% of all patients. Revision procedures included open and arthroscopic Eden-Hybinette, distal tibial allograft, iliac crest autograft, osteochondral glenoid allograft, and Bankart repair and/or capsular plication. These may all be viable techniques for revision surgery for a failed Latarjet procedure. All revision procedures showed improvements in PROMs including the Visual Analogue Scale, Constant score, subjective shoulder value, Walch-Duplay, and Rowe scores. Return to sports ranged from 46.1% to 94%. Recurrent instability rates ranged from 0% to 43.8%. Reoperation rates ranged from 0% to 31.3%. Overall satisfaction following a revision procedure ranged from 80% to 100%. A failed Latarjet procedure can be treated with various revision procedures such as open and arthroscopic Eden-Hybinette, distal tibial allograft, iliac crest autograft, osteochondral glenoid allograft, and Bankart repair and/or capsular plication. Overall, surgical management of the failed Latarjet results in improvements in PROMs, pain, return to sports, and decreased recurrent instability with a moderate complication rate. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? Are there sex differences in clinical presentation, general functioning and mood symptoms among older adults with bipolar disorder? • What is the main finding of this study? Female sex was associated with psychiatric hospitalization and male sex with higher rates of lifetime substance abuse disorders. • What is the meaning of the finding? Older aged women with bipolar disorder experience a more severe course of illness, emphasizing the importance of addressing sex-specific disparities in healthcare. Sex-specific research in adult bipolar disorder (BD) is sparse and even more so among those with older age bipolar disorder (OABD). Knowledge about sex differences across the bipolar lifespan is urgently needed to target and improve treatment. To address this gap, the current study examined sex differences in the domains of clinical presentation, general functioning, and mood symptoms among individuals with OABD. This Global Aging & Geriatric Experiments in Bipolar Disorder (GAGE-BD) study used data from 19 international studies including BD patients aged ≥50 years (N = 1,185: 645 women, 540 men).A comparison of mood symptoms between women and men was conducted initially using two-tailed t tests and then accounting for systematic differences between the contributing cohorts by performing generalized linear mixed models (GLMMs). Associations between sex and other clinical characteristics were examined using GLMM including: age, BD subtype, rapid cycling, psychiatric hospitalization, lifetime psychiatric comorbidity, and physical health comorbidity, with study cohort as a random intercept. Regarding depressive mood symptoms, women had higher scores on anxiety and hypochondriasis items. Female sex was associated with more psychiatric hospitalizations and male sex with lifetime substance abuse disorders. Our findings show important clinical sex differences and provide support that older age women experience a more severe course of BD, with higher rates of psychiatric hospitalization. The reasons for this may be biological, psychological, or social. These differences as well as underlying mechanisms should be a focus for healthcare professionals and need to be studied further. [ABSTRACT FROM AUTHOR]

Application of surgical skull pins causes hemodynamic fluctuations in neurosurgical procedures. To reduce this response, we describe the use of a novel nonpharmacologic method in the form of medical-grade sterile silicone studs to cushion the pressure of the skull pin in the adult population. This study aimed to evaluate the use of conventionally used fentanyl and medical-grade sterile silicone studs for the prevention of hemodynamic response to skull pin insertion. A prospective randomized pilot study was conducted of 20 adult patients categorized as American Society of Anesthesiologists class I and II scheduled for elective craniotomy in November 2022 in a tertiary-care hospital in Chandigarh, India. Patients were randomized into 2 groups: fentanyl only (FO group; n = 10) and medical-grade silicone studs (SS group; n = 10). Heart rate and mean arterial pressure were recorded at the following intervals: T1, baseline; T2, before induction; T3, after intubation; T4, before skull pin insertion; T5, T6, T7, T8, T9, and T10 at 0, 1, 3, 4, and 5 minutes after skull pin insertion. Demographic data (e.g., sex, age, disease pathology) were comparable between the groups. Although changes in heart rate between the 2 groups were comparable, there was a statistically significant decrease in mean arterial pressure from 1 minute to 5 minutes after pinning in patients with silicone studs compared with patients who received only fentanyl. The use of medical-grade silicone studs causes fewer hemodynamic fluctuations compared with fentanyl on skull pinning. Further studies with larger sample sizes are required to confirm the findings of this pilot study. [ABSTRACT FROM AUTHOR]

• Birth month in respect of RSV season plays an important role in the incidence of RSV-hospitalization. • Infants born preterm have a disproportional burden of severe RSV. • Timing and duration of a monoclonal antibody program is sensitive to a country's RSV season. Respiratory syncytial virus contributes to significant global infant morbidity and mortality. We applied a previously developed statistical prediction model incorporating pre-pandemic RSV testing data and hospital admission data to estimate infant RSV-hospitalizations by birth month and prematurity, focused on infants aged <1 year. The overall predicted RSV-hospitalization incidence rates in infants <6 months were 32.7/1,000 child-years (95 % CI: 31.8, 33.5) and 3.1/1,000 child-years (95 % CI: 3.0, 3.1) in infants aged 6-<12 months. Predicted RSV-hospitalization rates for infants aged <6 months were highest for infants born in April/May. Predicted rates for preterm infants born 29–32 weeks gestation were highest in March-May, whereas infants born >33 weeks had peak RSV-hospitalization rates from May-June, similar to late preterm or term births. RSV-hospitalization rates in the pre-pandemic era were highly seasonal, and seasonality varied with degree of prematurity. Accurate estimates of RSV-hospitalization in high-risk sub-groups are essential to understand preventable burden of RSV especially given the current prevention landscape. [ABSTRACT FROM AUTHOR]

Primary: Assess differences in pre-operative preparedness for patients undergoing in-office compared to virtual and video pre-operative counseling the time of laparoscopic hysterectomy. Secondary: Examine differences in (1) unplanned clinic or emergency department (ED) visits and (2) readmission rates within a 6-week post-operative period among the two groups. Single-center parallel design randomized controlled trial. Multi-specialty academic medical center in the United States. Patients 20 years and older who underwent a laparoscopic hysterectomy with the Department of Gynecologic Surgical Specialties for benign indications between 6/2021-2/2024. Patients were randomized to either an in-office or a virtual pre-operative counseling visit. The virtual group also received a link to an informational video to be viewed before their encounter. All participants received a 10-question survey to assess their preparedness for laparoscopic hysterectomy on the day of surgery. Of the 136 patients who consented to participate in the study, 114 patients received the survey intervention (59 in-office and 55 virtual). There was no statistically significant difference between in-office and virtual counseling preparedness scores based on the survey intervention with both groups reporting median scores corresponding to positive responses. Total scores for the survey were similar with 58.0(54.0,60.0) for in-office counseling and 58.0(55.0,60.0) for virtual counseling (p=0.9885). The number of unplanned clinic visits, visits to the Emergency Department (ED) and readmissions were the same for both groups 0.0(0.0,0.0) with p=0.1951, 0.5218, and 0.6091, respectively. Fischer exact and Wilcoxon rank sum tests were performed as applicable. There is no difference in patient preparedness for surgery, unplanned clinic or ED visits, or readmissions among the two study groups. This underscores the viability of virtual pre-operative counseling visits in the post-pandemic era and will facilitate access to minimally invasive gynecologic surgery. [ABSTRACT FROM AUTHOR]

Tobacco use remains the leading cause of preventable disease, disability, and death in the United States and is a significant cause of health disparities. The purpose of this paper is to update the Tobacco Control policy paper published over a decade ago by the American Academy of Nursing's Health Behavior Expert Panel Tobacco Control subcommittee. Members reviewed and synthesized published literature from 2012 to 2024 to identify the current state of the science related to nurse-led tobacco dependence treatment and implications for nursing practice, education, and research. The results confirmed that nurse-led tobacco dependence treatment interventions are successful in enhancing cessation outcomes across settings. Recommendations for nursing leaders include: promote tobacco dependence treatment as standard care, accelerate research on implementation of evidence-based treatment guidelines, reduce health disparities by extending access to evidence-based treatment, increase nursing competency in providing tobacco treatment, and drive equity-focused tobacco control policies. • Tobacco use and exposure to secondhand smoke contribute to health disparities. • Nurse-led intervention for tobacco dependence is effective across all settings. • Integration of evidence-based tobacco treatment is crucial to advance health equity. • Nursing science must address contextual and structural barriers to tobacco control. [ABSTRACT FROM AUTHOR]

Influenza vaccination is recommended to protect mothers and their infants from influenza. Few studies have evaluated the association between maternal influenza vaccination and child mortality. We aimed to evaluate the association between in utero exposure to seasonal inactivated influenza vaccine (IIV) and mortality among young children. This longitudinal, population-based cohort study included 191,247 maternal-child pairs in Western Australia between April 2012 and December 2017. Maternal vaccine information was obtained from a state-wide antenatal vaccination database. Mortality was defined as a record of a death registration. We used Cox proportional hazard models, weighted by the inverse-probability of treatment (vaccination), to estimate the hazard ratio of child mortality associated with in utero exposure to seasonal IIV. This study found no association between in utero exposure to seasonal IIV and mortality through age five years. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify the characteristics of advertising in the metaverse and its implications for brands and society. A group of 35 experts representing advertising agencies and brands from Central and Eastern Europe were interviewed. The findings are presented in the form of a conceptual model that provides a cartography for the landscape of metaverse advertising. Our results demonstrate that metaverse advertising uses existing formats (e.g. billboards, product placement), while also developing new ones (e.g. automated avatars, virtual products, and branded spaces). In addition, metaverse advertising is more focused on brand building than on direct, measurable impact. Advertising in the metaverse is not as precisely targeted as it is on the internet. Given their high up-front costs, these activities are currently more suitable for multinationals and well-known global brands. Metaverse advertising is not perceived to be associated with elevated brand risk. However it is burdened with myopia, understood as a lack of long-term perspective. Our findings reveal three stakeholder personas representing different approaches to metaverse advertising; including Cautious Pioneers, Empathic Pragmatists, and Blockchain Enthusiasts. We conclude by documenting the social consequences, capturing shifts towards automated communication, digital ownership, and the metaverse's potential to replace social media. • Advertising in the metaverse focuses on brand building rather than measurable impact. • Well-known global brands are typical advertisers in the metaverse. • Metaverse advertising suffers from myopia (lack of long-term perspective). • Cautious Pioneers, Empathic Pragmatists and Blockchain Enthusiasts are its stakeholders. • Trends towards automated communicationand digital ownership. [ABSTRACT FROM AUTHOR]

To perform a systematic review to compare clinical outcomes, complications, and reoperation rates of patients undergoing the Latarjet procedure with screw vs suture-button fixation. A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify clinical studies directly comparing screw vs suture-button fixation for the Latarjet procedure. The search terms used were shoulder screw suture button. Patients were evaluated based on reoperation rate, complication rate, recurrent instability, radiologic outcomes, and patient-reported outcomes. Graft and screw position were assessed via computed tomography. Seven studies (1 Level II, 6 Level III) met inclusion criteria, with 845 patients undergoing the Latarjet procedure with screw fixation (screw group) and 279 patients with suture-button fixation (suture-button group). Mean patient age ranged from 21.2 to 29.6 years. Mean follow-up time ranged from 6.0 to 40.8 months. The recurrent instability rate ranged from 0% to 2.5% in the screw group and 0% to 8.3% in the suture-button group. The reoperation rate ranged from 0% to 7.7% in the screw group compared to 0% to 1.9% in the suture-button group. One study reported significantly lower visual analog scale pain scores in the suture-button group compared with the screw group (1.5 vs 1.2, P =.003). No other studies reported significant differences in any patient-reported outcomes. There was no significant difference in horizontal or vertical graft position, graft union rate, or complication rate between groups in any study. The Latarjet procedure with screw fixation may result in a lower risk of recurrent instability compared to suture-button fixation, although screw fixation may also have a higher reoperation rate due to hardware-related complications. Level III, systematic review of Level II to III studies. [ABSTRACT FROM AUTHOR]

• Few studies have evaluated the long-term respiratory effects of maternal influenza vaccination. • Maternal influenza vaccination decreases the risk of acute respiratory infections among infants aged < 6 months. • Maternal influenza vaccination did not influence the risk of respiratory infection beyond two years of age. Influenza vaccination is recommended to protect mothers and their infants from influenza infection. Few studies have evaluated the health impacts of in utero exposure to influenza vaccine among children more than six months of age. We used probabilistically linked administrative health records to establish a mother–child cohort to evaluate the risk of influenza and acute respiratory infections associated with maternal influenza vaccination. Outcomes were laboratory-confirmed influenza (LCI) and hospitalization for influenza or acute respiratory infection (ARI). Adjusted hazard ratios (aHRs) accounted for child's Aboriginal status and were weighted by the inverse-probability of treatment. 14,396 (11.5%) children were born to vaccinated mothers. Maternally vaccinated infants aged < 6 months had lower risk of LCI (aHR: 0.33; 95% CI: 0.13, 0.85), influenza-associated hospitalization (aHR: 0.39; 95% CI: 0.16, 0.94) and ARI-associated hospitalization (aHR: 0.85; 95% CI: 0.77, 0.94) compared to maternally unvaccinated infants. With the exception of an increased risk of LCI among children aged 6 months to < 2 years old following first trimester vaccination (aHR: 2.28; 95% CI: 1.41, 3.69), there were no other differences in the risk of LCI, influenza-associated hospitalization or ARI-associated hospitalization among children aged > 6 months. Study results show that maternal influenza vaccination is effective in preventing influenza in the first six months and had no impact on respiratory infections after two years of age. [ABSTRACT FROM AUTHOR]

Background: The composite metric textbook outcome (TO) has recently gained interest as a novel quality measure. However, the criteria for defining a TO have not been rigorously defined and patient perspectives on the characteristics of TO are unknown. Methods: Patients who underwent major abdominal surgery at a single tertiary care center were administered a customized survey designed to ascertain their perspectives on defining TOs. The relationship between patient-reported and clinically defined TO rates was compared. Results: Among 79 patients who underwent gastrointestinal (51%), pancreatic (29%), hepatic (18%), or other major abdominal (3%) operations, 57% were female and 86% had an ASA class ≥3. Most patients underwent surgery for malignancy (87%) with 60% undergoing an open operation. Patients most commonly valued no mortality following surgery (96%), no reoperation (75%), and having a margin negative resection (73%) as "extremely important." In contrast, those outcomes that were most commonly valued as "not important at all" or "minimally important" were receiving a blood transfusion (24%) and not having any complications (13%). Using previously published criteria for TOs, 47 (60%) patients were classified as having a clinically defined TO; in contrast, 68 patients (86%) self-reported their outcome was textbook. Self-reported responses were concordant with clinically defined TO criteria 63% of the time (McNemar's test: S=15.2, p<0.01, evidence of disagreement). Conclusion: There was significant discordance between patient-reported versus clinically defined measures of TOs, suggesting patients value other considerations beyond traditional factors when evaluating the success of their surgery. Future studies should delineate these relationships and incorporate these factors to refine TO definitions. [ABSTRACT FROM AUTHOR]

Background It is thought that there is a high risk of zinc deficiency in India, but there are no representative national estimates. Objectives We aimed to evaluate the national and state-level prevalence of low serum zinc concentrations (SZCs) in Indian children from the nationally representative Comprehensive National Nutrition Survey. Methods Prevalence of low SZC, adjusted for C-reactive protein, was estimated among preschool (1–4 y; n  = 7874) and school-age children (5–9 y; n  = 10,430) and adolescents (10–19 y; n  = 10,140), using SZC cutoffs defined by the International Zinc Nutrition Consultative Group. Results Prevalence of low SZC was high among adolescents (31.1%; 95% CI: 29.8%, 32.4%), compared with school-age (15.8%; 95% CI: 15.3%, 16.3%) or preschool children (17.4%; 95% CI: 16.7%, 18.0%). However, stratification of prevalence by fasting status or using an alternative lower SZC cutoff independent of fasting status led to a reduction in prevalence by 3.7% or 7.8% in children <10 y, respectively. The prevalence of low SZC was higher among rural preschool children, those belonging to households with poor socioeconomic status, and those with severe stunting or underweight. Preschool children with diarrhea (22.6%; 95% CI: 20.8%, 24.4%), productive cough (22.7%; 95% CI: 18.5%, 27.5%), or malaria/dengue (38.5%; 95% CI: 29.4%, 48.2%) in the 2 wk preceding the survey had a higher prevalence of low SZC than those without morbidity (16.5%; 95% CI: 15.9%, 17.2%; 17.6%; 95% CI: 16.9%, 18.2%; and 17.5%; 95% CI: 16.8%, 18.1%, respectively). Conclusions The national prevalence of low SZC among preschool (17%) or school-age children (16%) was <20%, which is considered the cutoff indicating a problem of public health significance; but there were variations by state and socioeconomic status. In adolescents, however, the prevalence of low SZC was 31%, which warrants further investigation. The association of low SZC with diarrhea in preschool children necessitates better coverage of Zn administration in the management of diarrhea. [ABSTRACT FROM AUTHOR]

Early Fontan failure is a serious complication after total cavopulmonary connection, characterized by high central venous pressure, low cardiac output, and resistance to medical therapy. This study aimed to estimate postoperative central venous pressure in patients with total cavopulmonary connection using data routinely collected during preoperative assessment. We sought to determine if this metric correlated with measured postoperative central venous pressure and if it was associated with early Fontan failure. In this retrospective study, central venous pressure in total cavopulmonary connection was estimated in 131 patients undergoing pre–total cavopulmonary connection assessment by cardiac magnetic resonance imaging and central venous pressure measurement under general anesthesia. Postoperative central venous pressure during the first 24 hours in the intensive care unit was collected from electronic patient records in a subset of patients. Early Fontan failure was defined as death, transplantation, total cavopulmonary connection takedown, or emergency fenestration within the first 30 days. Estimated central venous pressure in total cavopulmonary connection correlated significantly with central venous pressure during the first 24 hours in the intensive care unit (r = 0.26, P =.03), particularly in patients without a fenestration (r = 0.45, P =.01). Central venous pressure in total cavopulmonary connection was significantly associated with early Fontan failure (odds ratio, 1.1; 95% confidence interval, 1.01-1.21; P =.03). A threshold of central venous pressure in total cavopulmonary connection 33 mm Hg or greater was found to have the highest specificity (90%) and sensitivity (58%) for identifying early Fontan failure (area under receiver operating curve = 0.73; odds ratio, 12.4; 95% confidence interval, 2.5-62.3; P =.002). This association was stronger in patients with single superior vena cava. Estimated central venous pressure in total cavopulmonary connection is an easily calculated metric combining preoperative pressure and flow data. Higher central venous pressure in total cavopulmonary connection is associated with an increased risk of early Fontan failure and is correlated with directly measured post–total cavopulmonary connection pressure. Identification of patients at risk of early Fontan failure has the potential to guide risk-mitigation strategies. In this study, cardiac magnetic resonance (CMR) imaging was performed in patients with bidirectional cavopulmonary connection (BCPC) undergoing preoperative assessment for total cavopulmonary connection (TCPC). We used routinely collected data: pulmonary blood flow (Qp), central venous pressure (CVP), and aortic flow. We calculated a metric that attempts to estimate how much CVP would increase should the TCPC be completed if all systemic flow is directed to the lungs. Given that early Fontan failure (EFF) is associated with high postoperative CVP, we investigated whether this metric was associated with EFF events and if it correlated to directly measured CVP in the TCPC during the intensive care unit (ICU) stay. Our study demonstrates an association between estimated TCPC pressure and EFF, and a moderate correlation with CVP measured in the ICU. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective: To investigate the proportions and trends in gender ratios of journal editorial boards in medicine, nursing, and pharmacy from 1995 to 2016.Design: This was a pooled cross-sectional evaluation of 21 high-impact medical, nursing, and pharmacy journals.Setting and Participants: The gender composition of editorial boards for each discipline was obtained. Gender expression was based on the person's name or other information available on the Internet.Outcome Measures: The proportion of all editorial board member positions, including editorial leadership positions, occupied by the underrepresented gender, and trends over time were measured.Results: A total of 5309 editorial board members and 312 editorial leadership positions were identified. From 1995 to 2016, women remained underrepresented across medicine and pharmacy journal editorial boards, whereas men remained underrepresented across nursing journal editorial boards. However, there were statistically significant increases in the representation of the underrepresented gender on editorial boards across all disciplines. Medicine was the only discipline to experience a statistically significant increase in the underrepresented gender of the editorial board being appointed to a leadership position; the proportion of women increased from 3% in 1995 to 35% in 2016.Conclusion: The gender gap in medicine and pharmacy journals appears to be narrowing. Although men continue to lag behind women in nursing journals, they are and have been overrepresented when considering the proportion of men practicing in the field. Overall, continued efforts are needed to resolve gender inequities in academic health sciences. [ABSTRACT FROM AUTHOR]